The purpose of the training program is to provide systematic predoctoral and postdoctoral research training into the biobehavioral and psychosocial factors involved in the management of Human Immunodeficiency Virus (HIV) infection. Training is coordinated with several extramurally funded NIH NIMH grants including a Program Project "Behavioral Management and Stress Responses in HIV/AIDS," and several R01 grants. Much of our research examines the effects of stressors and stress management interventions on successful adjustment to HIV and how these processes related to clinical, immunologic and virologic indicators of disease progression. Thus, in one project we are testing the effects of a Cognitive Behavioral Stress Management (CBSM) intervention on distress, adherence to combination anti-retroviral therapy (CART), CD4 cells and HIV viral load in gay and bisexual men with symptomatic HIV infected women. A third study examines the psychoneuroimmunologic mechanisms underlying the effects of CBSM on health status and immune reconstitution in HIV+ men and women by employing an acute stress reactivity paradigm. Subjects are assessed for autonomic (blood pressure catecholamines, ACTH, cortisol), and immuno- cellular (lymphocyte phenotypes, lymphocyte activation and adhesion markers, NK number and cytotoxicity and lymphoproliferative responses to mitogen) responses to two types of acute challenge, psychosocial (evaluative speech stress) and physical (bicycle exercise) stress, pre- and post-treatment. Much of our research focuses upon Black and Hispanic men and women so that training in cultural sensitivity is imperative, and this is made explicit in the training environment as well as through courses on topics such as Ethics, Ethnicity and Gender. Although emphasis at both the pre and postdoctoral level is upon research, available didactic training includes multiple courses in advanced statistics as well as courses in psychoneuroimmunology, psychophysiology, behavioral medicine, and psychological assessment and biobehavioral interventions in physical disorders. Coursework is also available in immunology, physiology, epidemiology, mechanisms of disease neurobiology, nutrition, pharmacology etc. Both pre- and postdoctoral trainees undergo rotations through our Program Project immunology, endocrinology, psychiatric and psychosocial assessment, health, statistics, and psychophysiologic instrumentation core laboratories.